Health Facts on Thyroglossal Cysts: Why It Is Important to Be Examined by an ENT Doctor

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( — June 29, 2020) — 

Your Thyroglossal cysts

Thyroglossal duct cysts are fluid filled pockets present in the midline of the neck. It is a congenital abnormality found in about 7% of the population. It is the most common cyst malformation in the neck region. Thyroglossal duct cysts are generally diagnosed in pre-schoolers or during mid-adolescence. Presence of these cysts can bring in recurrence of infection, while in rare cases it could induce malignancy as a papillary thyroid cancer. ENT specialists recommend the surgical removal of such thyroglossal cysts. Early intervention by a qualified ENT doctor will help to monitor your thyroglossal cysts to evaluate if they are benign or malignant in nature.

So what exactly are thyroglossal cysts?

Thyroglossal cysts are painless, round lumps or masses which are soft to the touch, found in the front midline of the neck, above the voicebox. These cysts are formed due to a congenital disorder when there is incomplete closure of the thyroglossal duct. When you suffer from an upper respiratory tract infection, these cysts can enlarge, causing discomfort.

How are thyroglossal cysts formed?

These cysts arise during embryonic development stages. When fetal development is going on, the thyroid gland is situated at the back of the tongue, however gradually, there is a natural migration down the neck, passing the hyoid bone. This hyoid bone anchors the tongue which occurs in front of the neck. When the thyroid gland descends, it forms a duct or small channel called the thyroglossal duct. Once the thyroid gland reaches the final position in the neck, it generally disappears, however, part of the duct sometimes remains, leaving a pocket where fluid accumulates.

Symptoms of thyroglossal cysts?

Apart from the occurrence of a lump in the neck, there could be the seepage of mucus from an opening in the skin close to the lump. Cysts which get infected, become swollen, red and tender in nature.

Patients with these cysts find it difficult to breathe and swallow. Recurrent infections with excessive swelling may be present. Sometimes, these go unnoticed until an infection occurs.

How are thyroglossal cysts diagnosed?

A visible neck swelling might be present. The symptoms of this neck swelling, maybe attributed to other medical causes and it is therefore important to make a conclusive diagnosis. Diagnosis is confirmed through:

  • Blood tests: blood tests can detect the amount of thyroid-stimulating hormone (TSH) which is an indication on how well the thyroid gland is working
  • Ultrasound examination: An ultrasound offers real time images, to determine if the mass present is cystic or solid, keeping a check, if the thyroid gland is normal in nature.
  • Thyroid scans: These scans help to confirm and diagnose the cysts. It is essential prior to surgical excision. Through 3D imaging, CT and MRI scans help in evaluating the extent of the thyroglossal cyst.
  •  Fine needle aspiration: This test helps in identifying if the cells of the thyroglossal cyst are benign or malignant.
  • X-rays using a contrast dye: The X-rays help in getting a close look at the neck and the cyst. The usage of contrast dyes gives a clearer picture of the cyst.

How are thyroglossal cysts treated?

ENT doctors generally recommend the surgical removal of such cysts. The treatment options are determined based on the age of the individual, general health and severity of symptoms.

  • Medication: Infected thyroglossal cysts are treated with antibiotics, even if surgery is planned. If infection is present, it makes the surgery more difficult and increases re-occurrence of such cysts.
  • Surgery: The standard treatment option is conducting a procedure called sistrunk procedure. This helps to effectively remove the cyst. Recurrence only happens if part of the tissue is left behind following surgery. It is important that the surgery is performed by experienced hands. The ENT Clinic in Singapore has qualified and reputed otolaryngologist surgeons who are competent in carrying out the procedure. The team of Dr Chris Hobbs, Dr Annabelle Leong, and Dr Jeeve Kanagalingam have extensive experience with this condition.

What to expect during the Sistrunk procedure?

During the sistrunk procedure, the patient is  administered general anaesthesia and a small incision is made in front of the neck to expose the skin and muscles above the cyst. The cyst tissue is removed from the neck along with a part of the hyoid bone, together with any residual tissue of the thyroglossal duct. The muscles are then sutured. Patients often remain hospitalised overnight after the procedure. The entire procedure generally will take up to 90 minutes.

Complications which could occur post Sistrunk procedure

It’s important to perform the procedure properly to ensure that complications are minimised. Complications can be mild to severe and some of the commonly observed complications include:

  • Bleeding
  • Clotting
  • Infection
  • Scarring
  • Nerve damage
  • Hyperthyroidism

Following surgery it is advised to rest up to 3 weeks and avoid driving for 2 weeks. You will be called for a post-operative follow-up appointment and in case you have pain, fever or redness, do not hesitate to reach your ENT doctor.

The ENT specialists at the ENT Clinic Singapore have an established reputation in the field of otolaryngology with a cumulative experience of over 5 decades. With state-of-the-art facilities and a commitment towards excellence and greatest care for patients, the center is well equipped to conduct surgeries for thyroglossal cysts or any ENT related surgery successfully.